【摘要】 目的探讨甲磺酸伊马替尼新辅助治疗原发直肠胃肠间质瘤(GIST)的疗效及安全性。方法 40例直肠GIST患者口服甲磺酸伊马替尼片400mg/天,连续口服6个月后评估手术指征。根据肿瘤大小和位置分别采用局部切除术、直肠低位前切除术和腹会阴联合直肠癌根治术。结果按RECIST 1.1版标准评价,获CR 3例,PR 31例,SD 4例,PD 2例;有效率(RR)为85.0%,疾病控制率(DCR)为95.0%;按Choi标准评价,获CR 3例,PR 28例,SD 7例,PD 2例;RR为77.5%,DCR为95.0%。治疗后获R0切除38例。40例患者的1年生存率为100.0%,2年生存率为95.0%。不良反应以轻度水肿发生率最高,为72.5%,其次为白细胞减少(47.5%);其他不良反应包括乏力、腹痛、胃肠道反应等,均可耐受。结论直肠GIST患者术前使用甲磺酸伊马替尼辅助治疗,能够扩大患者的手术指征,提高R0切除率,疗效确切,安全性高,可以作为直肠GIST个体化治疗方案之一。更多还原

【Abstract】 Objective To explore the efficacy and safety of imatinib mesylate as neoadjuvant treatment for rectal stromal tumors patients. Methods Forty cases of rectal stromal tumor patients were given imatinib mesylate tablets orally,400 mg / d lasting for6 months,and then the operation indication was assessed. According to the size and location of the tumor,patients were underwent local excision,rectal low anterior resection or abdominoperineal resection combined with rectal cancer treatment. Results By RECIST 1. 1criterion,3 cases got CR,31 cases had PR,4 cases got SD and 2 cases were of PD. The response rate( RR) was 85. 0%,and the disease control( DCR) rate was 95. 0%. By Choi criterion,3 cases got CR,28 cases had PR,7 cases got SD and 2 cases were of PD.RR was 77. 5%,and DCR was 95. 0%. R0 resection was performed in 38 cases. The 1-year survival rate was 100. 0%,and 2-year survival rate was 95. 0%. The incidence rate of mild edema was the highest(72. 5%),followed by leukopenia( 47. 5%),and the other adverse effects included fatigue,abdominal pain and gastrointestinal reaction,which were tolerable. Conclusion Preoperative use of imatinib mesilate in rectal stromal tumors can expand the indications of operation,as well as raise R0 resection rate with stable efficacy and safety,and this neoadjuvant treatment can be used as individual treatment of rectal stromal tumors.更多还原